title: Efficacy and treatment tolerance in older patients with NSCLC: a meta-analysis of five phase III randomized trials conducted by the Hellenic Oncology Research Group.
abstract: BACKGROUND
  Approximately 50% of newly diagnosed cases of non-small-cell lung cancer (NSCLC) are observed in patients >65 years, while 30%-40% of cases occur in patients >70 years.
  
  
  METHODS
  The objective of the current study was to determine (i) the number of elderly (>70 years) patients with advanced/metastatic NSCLC enrolled in phase III trials of the Hellenic Oncology Research Group, (ii) the treatment-related toxicity observed in these patients compared with their younger counterparts, and (iii) the differences in terms of response rate, time to tumor progression (TTP), and overall survival (OS) between younger and older patients.
  
  
  RESULTS
  Pooled data from five clinical trials including 1845 patients were analyzed; 1421 (77%) and 424 (23%) were <70 years and ≥70 years, respectively. No difference was observed in terms of the overall response rate and TTP. There was an OS difference between young and older patients, with higher risk for death in older patients. However, when the analysis was carried out after omitting a trial that showed a different trend, no difference was observed. Older patients experienced higher toxicity.
  
  
  CONCLUSIONS
  This report supports the feasibility of chemotherapy treatment for older NSCLC patients. Optimization of treatment of older NSCLC patients requires the design of prospective older-specific phase III trials for these patients.
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece. Electronic address: georgsec@med.uoc.gr.
authors.forename: A G
authors.initials: AG
authors.lastname: Pallis
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Karampeazis
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: L
authors.initials: L
authors.lastname: Vamvakas
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: N
authors.initials: N
authors.lastname: Vardakis
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kotsakis
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Bozionelou
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kalykaki
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Hatzidaki
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Mavroudis
authors.affiliation: Hellenic Oncology Research Group (HORG), Athens, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Georgoulias
mesh_terms: D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D017326:Clinical Trials, Phase III as Topic / Q000379:methods; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D015337:Multicenter Studies as Topic; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D015996:Survival Rate; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000077235:Vinorelbine; D000093542:Gemcitabine
chemical_list: D043823:Taxoids; D003841:Deoxycytidine; D000077143:Docetaxel; D014747:Vinblastine; D002945:Cisplatin; D000077235:Vinorelbine; D000093542:Gemcitabine